Hello
Thanks for your query.
Breast abscess is caused by a bacterial infection. The most common type of bacteria involved in a breast abscess is Staphylococcus aureus. Bacteria enter through a scratch in the skin or a tear in the nipple.

A number of factors increase your risk of developing breast abscess. Not all people with these risk factors will develop a breast abscess.
Risk factors for breast abscess in women who are not breastfeeding include:
Being of child-bearing age
Being overweight
Having a history of previous breast abscess
Inflammatory breast cancer (a rare type of breast cancer)
Smoking or other tobacco product use
A previous traumatic injury to the breast tissue and pre existent hematoma is a good nurture ground for bacteria and could be the most possible cause in your case for development of an abscess.



If you are not breastfeeding, you may be able to lower your risk of breast abscess by:
Avoiding use of tobacco products
Maintaining a healthy weight
Preventing irritation or cracking of the breast skin and nipples

The most common symptoms of breast abscess include:
Breast engorgement (swelling)
Breast pain
Itching
Nipple discharge
Nipple tenderness
Swelling, warmth and redness of the breast tissue
Tender or enlarged lymph nodes in the armpit on the affected side

In women who are not breastfeeding, the presence of an abscess may be a symptom of new-onset diabetes or an uncommon type of inflammatory cancer. In rare cases an abscess can result in a body-wide infection (sepsis, a life-threatening bacterial blood infection) if the infection spreads to the bloodstream.

An abscess can generally be diagnosed based on your description of symptoms and a physical exam by your health care provider.
Your health care provider may choose to administer tests such as a white blood cell count (WBC). A WBC test will measure the extent of the body’s immune reaction.

Broad-spectrum antibiotic medications used to treat breast abscess include:
Cephalosporins, such as cefazolin (Cefazil) or cephalexin (Keflex)
Erythromycin (E-mycin, E.E.S.)
Penicillins, such as penicillin G potassium
Surgical drainage of the abscess may be required in addition to antibiotic therapy. During surgical drainage of a breast abscess, a small cut will be made in the lump. The pus inside the abscess will be broken up and washed away. Your health care provider may leave a small drain in the incision to release any additional pus. The incision will be protected with a bandage to keep the area clean and dry. Your incision may not be sewn closed in order to let it heal from the inside to the outside.
Many health care providers now offer ultrasound-guided abscess drainage. In this method, ultrasound imaging is used to pinpoint the location and depth of the abscess. A needle is then inserted into the abscess and the pus is drained, or aspirated, through the needle. Ultrasound-guided aspiration is considered less invasive than surgical drainage.

You can speed your recovery by:
Alternating between taking warm showers and applying a cold compress to the affected area
Applying a warm, moist compress to the affected area several times a day
Engaging in proper hygiene to keep skin healthy
Moisturizing nipples to prevent drying or cracking

If the abscess is in initial stages, your doctor would try to manage it by painkillers and anti inflammatory medication, switching over to antibiotics / drainage later if required.
All the best.
Feel free to discuss further.

---

Hi again.
Unfortunately I do not have the details of the abscess - the size, severity of infection etc.
SO I cannot say how long it would take.
If it responds to treatment, it would disappear within a week or two.
If it needs drainage, it would disappear immediately, and then the drainage site would heal within two weeks.
As I said, your antecedent history of breast trauma could predispose you to infection, as old collected blood ( in the hematoma and bruise ) is a good source for bacteria to thrive.
Whether your immunity is low depends on the tests. You can have a WBC count done and general health status evaluated, blood sugars etc done to see if you are diabetic or not.
Chances of abscess over the abdominal scar are very low, as the breast tissue is loose and more prone to abscess formation.

---

The doctor would mention you were diabetic if you were tested and found positive.
Please confirm about that.
If you are not responding to antibiotics, you might need to have a drainage.
The PT was right in not apply ultrasound as it might dissipate the infection. XXXXXXX 4 is fine enough, but if you have high grade fever before that, you should visit the ER.
There is no topical pain reliever for a breast abscess.
Please take the prescribed pain medication if the pain is unrelenting.
You CAN try hot compresses.

---